Regan isoenzyme of alkaline phosphatase as a tumour marker for renal cell carcinoma

Abstract

Alkaline phosphatase is an enzyme present in all tissues of the human body. Several isoforms of this enzyme have been described with different catalytic nature, stability and antigenic structure. Rises in the activity of alkaline phosphatase are recognised in various states including bone diseases, liver disease, pregnancy, hyperthyroidism and malignant processes. The Regan isoenzyme, a rare variant of placental alkaline phosphatase, has been identified circulating in association with various tumours. The reported case describes a rising Regan isoform of alkaline phosphatase concentrations that led to a new diagnosis of occult renal cell carcinoma and persistently elevated activity postoperatively signposting persistent or recurrent disease. KeywordsIsoenzymes, amylase, cancer Accepted: 8th February 2014 Case report A 71-year-old woman was referred from primary care with a history of persistently elevated alkaline phosphatase (AP) for 11 months prior to referral, with normal results for serum bilirubin, transaminases and g-glutamyl transpeptidase. Laboratory records had shown previous AP results to be within reference limits. Medical and surgical history included chronic obstructive pulmonary disease (COPD), primary hypothyroidism, dyslipidaemia, obesity, hysterectomy and a history of recurrent drop-attacks likely secondary to partial complex seizures which responded well to carbamazepine treatment. The list of daily medications included thyroxine, atorvastatin, carbamazepine, vitamin D, folic acid, paracetamol, as well as regular inhalers (tiotropium, salbutamol and a combined budesonide/formoterol preparation). There was a family history of colon cancer.The myeloma screen was negative. Plasma carbamazepine concentration was stable and within the therapeutic interval since 2009. Hypovitaminosis D (25 hydroxyvitamin D concentration ¼ 21 nmol/L) was corrected with oral cholecalciferol supplementation, but a few months later despite being vitamin D replete (62 nmol/L), AP concentrations remained elevated and continued to rise further. Serum C-terminal collagen

Tunable phosphatase-sensitive stable prodrugs of 5-aminolevulinic acid for tumor fluorescence photodetection

“…Since 5-ALA-induced PpIX is selective for tumors, we hypothesized that the introduction of an N-terminal group that can be activated by ubiquitously expressed enzymes would circumvent this problem. Therefore, we have focused our efforts on the design and synthesis of novel classes of 5-ALA derivatives modified at the amino group that can be activated in vivo by alkaline phosphatases [35], ubiquitous enzymes present in all tissues and known to be overexpressed in certain types of tumors [36][37][38][39]. To the best of our knowledge this is the first time that the 5-amino group has been successfully protected using a phosphate group.…”

Overview of Optical and Electrochemical Alkaline Phosphatase (ALP) Biosensors: Recent Approaches in Cells Culture Techniques

“…Fishman (1980) contends that PLAP is sometimes found in individuals with ulcerative colitis or polyposis of the colon, and it is through this that they enhance the capability of acquiring cancer [17]. Bukowczan et al also examined that PLAP has a relationship with different tumors such as renal cell carcinoma (RCC) [18].…”

Novel fluorescent nanoprobe based on hyaluronic acid and polyethyleneimine functionalized graphene oxide for detecting hyaluronidase as tumor marker

“…Studies have shown that the increase of Regan isoenzyme of alkaline phosphatase is closely related to the occurrence of occult renal cell carcinoma. The continuous increase after operation indicates the persistence or recurrence of the disease 2 . Leucine aminopeptidase (LAP) is also an important marker for cancer diagnosis as it is overexpressed in many cancers.…”